The explosive epidemic of obesity that has occurred over the past decade has affected all segments of the population; but has had its most detrimental impact on high-risk ethnic populations. Despite the compelling evidence that obesity increases the risk of CVD mortality, the pathobiological pathways that mediate this increased risk remain to be further elucidated. The metabolic syndrome (MetS) has recently been defined to capture the cluster of characteristics associated with obesity and high CVD risk. We are intrigued by the paradoxical observation that African-Americans (AA) have a lower prevalence of the MetS compared to whites despite a higher prevalence of obesity and hypertension. This observation suggests that current clinical criteria fail to identify obese AA at high risk for CVD. Further research in ethnic populations is necessary to guide more effective preventive interventions. It is postulated that ethnic differences in obesity-related CVD involve a complex interplay between behavioral, cultural, socio-economic and biological determinants. The theme of this Morehouse-Emory Partnership Program focuses on elucidating the etiologic basis of ethnic differences in obesity-related CVD and discovering new intervention strategies to ameliorate CV health in all communities. The proposed Program uses a multi-disciplinary strategy to systematically characterize ethnic differences in obesity-related CVD and develop effective therapeutic interventions by drawing upon the fields of physiology, biochemistry, vascular biology, psychology, public health, nursing and clinical medicine. In a thematic series of inter-related studies, our Program's approach to elucidating ethnic disparities integrates the analysis of psycho-social parameters within the context of ethnic communities with the assessment of novel biomarkers and !assays of vascular function/structure that characterize differences in pathobiological pathways. This collaborative multi-investigator team is built upon a complementary partnership between Emory University and the Morehouse School of Medicine (MSM). In accordance with the RFA, the Program has at least four research-specific and two training-specific aims within Projects the subprojectsI and the shared resource Cores. Each project/core involves the synergy of a joint effort with investigators from both institutions. The specific aims are: Aim 1: Define the influence of psychosocial/cultural factors and biological mediators as determinants of ethnic disparities in obesity and the metabolic syndrome in a population-based bi-racial cohort. Aim 2: Define the effectiveness of a patient-centered lifestyle intervention to enhance the health of African-American patients with the metabolic syndrome in the context of community-based clinical practices. Aim 3: To assess the impact of innovative lifestyle intervention strategies on conventional and novel biomarkers of vascular disease risk in African-Americans. Aim 4: To enhance the education/training of fellows/practitioners engaged in CVD disparities research/practice and promote partnerships that enhance cardiovascular health within ethnic communities.